Evaluation and Management – Claim Documentation Requirements

Code Code Description Documentation Required
99354 Prolonged physician services Clinical notes

In addition, HMSA may require submission of clinical records before or after payment of claims for the purpose of investigating potential fraudulent, abusive or other inappropriate billing practices, but only as long as there is a reasonable basis for believing such investigation is warranted.


Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.